IX.

PATHOPHYSIOLOGY

Predisposing Factors: Precipitating Factors:

 Age – 7 y.o  Previous dengue infection
 Environmental condition
 Mosquito carrying a different strain
 Geographical area

Aedes aegypti (dengue virus carrier): 8-12 days of

viral replication on mosquitos’ salivary glands
Redness

Bite from mosquito (Portal of Entry in the Skin) Itchiness in

the area

Inoculation of dengue virus in the circulation/blood

(Incubation Period: 3-14 days)

Rapid dissemination of dengue virus in the blood

Inflammatory Response

Stimulates WBCs

macrophages Immunoglobulins
& monocytes (specific antibodies of
previous virus strain)

paracetamol Phagocytize the Unable to Attachment to

(Tempra) dengue virus deactivate the dengue virus
2 tsp 250 mg
(125mg/5ml) through the Fc the virus to facilitate
PRN if T< receptor (FcR) phagocytosis
37.8 ◦C

↓WBC ct:
Virus Replication
3.8%
takes place –
Multiplies & Release (5.0-15.0%)
to the blood stream

Febrile:
◦ Systemic
39.2 C
◦ Infection Legend:
(36.5-37.5 C)
-medication
Dengue Fever
-signs and symptoms

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 Entry to the
heart

Entry &
Replication inside
the myocytes

Activates
Natural Killer
Cells
↑Monocyte
Count:
Release of Activation of 16.6 %
Macrophages (8-14%)
Interferon

Viral Release of
phagocytosis interleukins 1β and 2,
tumor necrosis factor
↑Lymphocyte Activation of natural
Count: killer cells
61.3 % Activation of T cells
(20-50%)
Elimination of infected
myocytes

Lysis of Lysis of Inhibition of viral

infected noninfected replication
myocytes myocytes

Sinus Arrythmia
Myocardial inflammation and damage
Presence of
Heart Murmur

Dysfunction
Fatigue
RR: 55cpm
Decreased cardiac output ↑ Hgb:
BP: 50/40
mmhg 15.4g/dL
(11-14g/dL)
Decreased supply of O2 to
body cells

Viral Myocarditis
- dobutamine 20
mL IVTT in 200cc 5
D5W for 12 hrs terbutaline sulfate
- dopamine 1 amp 5 mL P.O TID
IVTT in 200cc
D5W for 12 hrs
via infusion pump

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